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| ==Overview== | | ==Overview== |
| The [[Gold standard (test)|gold standard]] for diagnosing temporal arteritis is [[biopsy]], which involves removing of a small part of the [[Blood vessel|vessel]] and examining it microscopically for [[Macrophage|giant cells]] infiltrating the tissue. Since the blood vessels are involved in a patchy pattern, there may be unaffected areas on the [[Blood vessel|vessel]] and the [[biopsy]] might have been taken from these parts. So, a negative result does not definitely rule out the diagnosis. Findings diagnostic of temporal arteritis include skip lesions and normal intervening segments, [[Tunica intima|intimal]] thickening, with prominent [[Cell (biology)|cellular]] infiltration, [[Lymphocyte|lymphocytes]] in the internal or external [[Elastic fiber|elastic]] lamina or [[adventitia]], areas of [[necrosis]] may be present in the arterial wall, [[Granuloma|granulomas]] containing [[Multinucleate|multinucleated]] [[Histiocyte|histiocytic]] and foreign body [[Macrophage|giant cells]], [[T helper cell|helper T-cell]] [[Lymphocyte|lymphocytes]], [[Plasma cell|plasma cells]], and [[Fibroblast|fibroblasts]]. Risks of [[Superficial temporal artery|temporal artery]] [[biopsy]] are temporary or permanent damage to the temporal branch of the [[facial nerve]], [[infection]], [[bleeding]], [[hematoma]], and [[dehiscence]].
| | There are no other diagnostic studies associated with [disease name]. |
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| | [Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3]. |
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| | Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3]. |
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| ==Other Diagnostic Studies== | | ==Other Diagnostic Studies== |
| *[[Superficial temporal artery|Temporal artery]] [[biopsy]] may be helpful in the diagnosis of temporal arteritis. Findings diagnostic of temporal arteritis include:<ref name="pmid7728064">{{cite journal| author=Pountain G, Hazleman B| title=ABC of rheumatology. Polymyalgia rheumatica and giant cell arteritis. | journal=BMJ | year= 1995 | volume= 310 | issue= 6986 | pages= 1057-9 | pmid=7728064 | doi= | pmc=2549437 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7728064 }} </ref><ref name="pmid10817557">{{cite journal| author=Weyand CM, Fulbright JW, Hunder GG, Evans JM, Goronzy JJ| title=Treatment of giant cell arteritis: interleukin-6 as a biologic marker of disease activity. | journal=Arthritis Rheum | year= 2000 | volume= 43 | issue= 5 | pages= 1041-8 | pmid=10817557 | doi=10.1002/1529-0131(200005)43:5<1041::AID-ANR12>3.0.CO;2-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10817557 }} </ref>
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| **Skip lesions and normal intervening segments
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| **Intimal thickening, with prominent [[cellular infiltration]]
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| **[[Lymphocyte|Lymphocytes]] in the internal or external elastic lamina or [[adventitia]]
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| **Areas of [[necrosis]] may be present in the [[Artery|arterial]] wall
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| **[[Granuloma|Granulomas]] containing [[Multinucleate|multinucleated]] [[Histiocyte|histiocytic]] and foreign body [[Macrophage|giant cells]], [[T helper cell|helper T-cell]] [[Lymphocyte|lymphocytes]], [[Plasma cell|plasma cells]], and [[Fibroblast|fibroblasts]]<ref name="pmid23523078">{{cite journal| author=Liozon E, Ly KH, Robert PY| title=[Ocular complications of giant cell arteritis]. | journal=Rev Med Interne | year= 2013 | volume= 34 | issue= 7 | pages= 421-30 | pmid=23523078 | doi=10.1016/j.revmed.2013.02.030 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23523078 }} </ref>
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| *A positive [[Superficial temporal artery|temporal artery]] [[biopsy]] is diagnostic of temporal arteritis with a [[Specificity (tests)|specificity]] of 100% and a [[Sensitivity (tests)|sensitivity]] as low as 15% to as high as 87%.<ref name="pmid17251465">{{cite journal| author=Niederkohr RD, Levin LA| title=A Bayesian analysis of the true sensitivity of a temporal artery biopsy. | journal=Invest Ophthalmol Vis Sci | year= 2007 | volume= 48 | issue= 2 | pages= 675-80 | pmid=17251465 | doi=10.1167/iovs.06-1106 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17251465 }} </ref>
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| *Clinical features of severity correlate with the [[Histopathology|histopathological]] changes on the [[Superficial temporal artery|temporal artery]] [[biopsy]].<ref name="pmid7242167">{{cite journal| author=Moya Mir MS, Martín Jiménez T, Barbadillo R, Martín Martín F, Sánchez Ariño A, Magnani E| title=[Giant cell arteritis: diagnostic value of a second biopsy of the temporal artery (author's transl)]. | journal=Med Clin (Barc) | year= 1981 | volume= 76 | issue= 10 | pages= 452-3 | pmid=7242167 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7242167 }} </ref>
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| *A positive [[biopsy]] after initiation of steroid treatment vary from 10% after 1 week to 86% after 4 or more weeks of treatment.<ref name="pmid7728064">{{cite journal| author=Pountain G, Hazleman B| title=ABC of rheumatology. Polymyalgia rheumatica and giant cell arteritis. | journal=BMJ | year= 1995 | volume= 310 | issue= 6986 | pages= 1057-9 | pmid=7728064 | doi= | pmc=2549437 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7728064 }} </ref><ref name="pmid11973248">{{cite journal| author=Ray-Chaudhuri N, Kiné DA, Tijani SO, Parums DV, Cartlidge N, Strong NP et al.| title=Effect of prior steroid treatment on temporal artery biopsy findings in giant cell arteritis. | journal=Br J Ophthalmol | year= 2002 | volume= 86 | issue= 5 | pages= 530-2 | pmid=11973248 | doi= | pmc=1771122 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11973248 }} </ref>
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| *Most physicians with high clinical suspicion despite an initial negative [[biopsy]] would still recommend a second contralateral [[biopsy]], given the consequences of a missed [[diagnosis]] of temporal arteritis.<ref name="pmid11567973">{{cite journal| author=Riordan-Eva P, Landau K, O'Day J| title=Temporal artery biopsy in the management of giant cell arteritis with neuro-ophthalmic complications. | journal=Br J Ophthalmol | year= 2001 | volume= 85 | issue= 10 | pages= 1248-51 | pmid=11567973 | doi= | pmc=1723724 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11567973 }} </ref>
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| *Risks of [[Superficial temporal artery|temporal artery]] [[biopsy]] are temporary or permanent damage to the [[Temporal branches of the facial nerve|temporal branch of the facial nerve]], [[infection]], [[bleeding]], [[hematoma]], and [[dehiscence]].
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| ====Video====
| | *There are no other diagnostic studies associated with [disease name]. |
| {{#ev:youtube|yomjRscIxfE}}
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| | *[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include: |
| | **[Finding 1] |
| | **[Finding 2] |
| | **[Finding 3] |
| | *Other diagnostic studies for [disease name] include: |
| | **[Diagnostic study 1], which demonstrates: |
| | ***[Finding 1] |
| | ***[Finding 2] |
| | ***[Finding 3] |
| | **[Diagnostic study 2], which demonstrates: |
| | ***[Finding 1] |
| | ***[Finding 2] |
| | ***[Finding 3] |
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| ==References== | | ==References== |